Cutting and Self-Harm: Warning Signs and Treatment
Parents should watch for symptoms and encourage kids to get help.
When An Inpatient Program Is Necessary
When kids just can't break the cycle through therapy, an inpatient program
like SAFE Alternatives can help.
In their 30-day program, Lader and Conterio only treat patients who
voluntarily request admission. "Anybody who can't perceive that they have a
problem will be hard to treat," says Conterio. Those who come to us have
recognized that they have a problem, that they need to stop. We tell them in
the acceptance letter we send them, 'This is your first step toward empowering
When admitted to SAFE, patients sign a contract that they won't self-injure
during that time. "We want to teach them to operate in the real world," says
Lader. "That means making choices in response to emotional conflict --
healthier choices, rather than just self-injuring to feel better. We want them
to understand why they are angry, show them how to handle their anger."
Although self-harm is not allowed, "we don't take away razors," Conterio
adds. "They can shave. We don't take belts or shoe laces. The message we're
sending is, 'We believe you're capable of making better choices.'"
Turning Inward to Heal
Many kids haven't thought about it at all -- exactly why they self-injure,
says Lader. "It's like any addiction, if I can take a pill or self-medicate in
some way, why deal with the problem? We teach people that cutting only works in
the short term, and that it will only get worse and worse."
When kids learn to face their problems, they will quit self-harming, she
adds. "Our goal is to get them to communicate what's wrong. Babies don't have
the capacity for language, so they use behavior. These adolescents regress to
that preverbal state when they self-harm."
Individual and group therapy are the hubs of this treatment program. If
there is underlying depression or anxiety, antidepressants may be prescribed.
The patients also write regularly in their journals -- to learn to explore and
express their feelings.
Helping them gain self-respect and self-esteem is a critical treatment goal,
Conterio tells WebMD.
"Many kids have difficulty dealing with situations and people that make them
angry," Lader adds. "They don't have great role models for that. Saying no,
standing up to people -- they don't really believe they're allowed to do that,
especially girls. But if you can't do that, it's very difficult to maneuver the
world, survive in the world without someone stronger, more capable than you to
fight your battles."